The timetabling of the work programme is a matter for the National Institute for Clinical Excellence, although I understand that it should have finalised its deliberations on beta interferon by 30 May, leaving time for appeals and dissemination of the results. The results of NICE' s appraisals should be available in late summer this year.
I am grateful to the Minister for that reply, but how does he reconcile the addition of affordability to the remit of NICE with the Government's policy statement in June 1998 that NICE would not become a national council for rationing? Does he not agree that all patients in the national health service should expect the best possible drug for the treatment of their condition?
It is certainly the case that NICE will provide authoritative guidance on the clinical effectiveness and cost-effectiveness of treatments. That will enable us to ensure that clinically effective and cost-effective treatments are spread as quickly as possible throughout the national health service, and that the best use is made of NHS resources. I think, to be fair, that the hon. Gentleman has misunderstood the nature of the amendment to the establishment order of NICE earlier this year, which was to ensure that it could examine questions of cost-effectiveness.
Will my hon. Friend reaffirm that one of the principal purposes of NICE is to overcome the long-standing problems of postcode prescribing of drugs such as beta interferon? What assurances can he give multiple sclerosis sufferers that the current NICE study will lead to greater consistency, transparency and equity in prescribing this drug?
My hon. Friend is absolutely right. One of the features of the national health service that, regrettably, we inherited from the previous Government was the unacceptable variations in access to care and treatment in different parts of the country. The guidance that is being followed on beta interferon was introduced by the previous Government. One of the great strengths, we hope, of NICE is that by providing consistent guidance to health authorities and to clinicians, those unacceptable variations in treatment and care for a whole range of conditions will be tackled effectively.
Is the hon. Gentleman aware that I have been in correspondence with his Department about the problems in the Lincolnshire health authority area? Is he further aware that over the past four and a half years, of those for whom beta interferon has been recommended as treatment 81 per cent. remain untreated? Is he also aware that the Lincolnshire health authority contends that those numbers are because there are insufficient funds available within the Lincolnshire health authority area to treat more people? Given that, what advice does he have that will ensure that more people can be treated with beta interferon in the Lincolnshire health authority area?
I am grateful to the right hon. and learned Gentleman for recognising in his question that the variations in access to care stemmed from the previous Administration. My advice is that the reason for referring beta interferon—and a range of other important, controversial, questioned drugs such as the taxanes—to NICE is to ensure that authoritative guidance is available to the right hon. and learned Gentleman's authority, and to others, which they should take full account of when making decisions.
Such guidance did not exist previously and that is why, on a range of treatments, health authorities take different decisions about priority or about the effectiveness or availability of different drugs. The National Institute for Clinical Excellence will enable us to tackle that problem.
One of my constituents moved from Burnley to Cheshire to obtain beta interferon under the present arrangements, which, as my hon. Friend rightly pointed out, came from the previous Conservative Government. Will he give an assurance that everything possible is being done to ensure that when the current assessment has been completed, provision will be clinically based—on medical need and not on cost?
My hon. Friend raises the sort of example of which all hon. Members will be aware. NICE will give guidance both on the clinical effectiveness and the cost-effectiveness of the drugs—that is the basis on which the institute was set up. It will ensure that the most clinically and cost-effective treatments are spread rapidly throughout the NHS and that we make the best use of NHS resources—both factors will be taken into account.
One understands the role of NICE, but can we have an assurance that cost-effectiveness will not rule out modern, more expensive drugs that could be cheaper for the health service in the long run and more effective in the care of patients? What about those patients who have already benefited from beta interferon, but have been taken off the drug because they were taking part in a random test? The patients and the clinicians discovered the benefits; cannot the patients continue their treatment?
The hon. Gentleman raises a couple of important points. When any drug is under consideration by the national institute, it is expected that manufacturers and others—such as patients' groups—will submit evidence on the best use of both NHS and personal social services resources, so that the full economic impact can be taken into account. Indeed, it will be open to people to submit evidence over a wider range of costs. I hope that that reassures him.
Sometimes, however, there are cases in which highly hyped new drugs are not necessarily any better than long-standing treatments. One of the advantages of NICE is that it distinguishes between them. As for clinical tests, the job of NICE will be to look at those procedures that have completed their clinical trials and would, in normal circumstances, be made available to the health service and to assess them to see which are clinically and cost-effective.